Exploring fairness in health care reform

This article considers the increasing challenge of the fair allocation of scarce public health care resources by focusing on services for women and girls. It considers different ways of thinking about fairness in health care reform, the role of courts in promoting fairness, and the use of affirmative action measures to remedy health disparities. The health of individuals and populations is shown to be affected by clinical services, the organization and functioning of health systems, and underlying socio-economic determinants. Different theories of justice are addressed that affect assessments of fairness, considering availability, accessibility, acceptability of and accountability for services. The transition in judicial dispositions is traced, from deference to governmental resource allocation decisions to evidence-based scrutiny of governmental observance of constitutional and human rights legal obligations. The appropriate use of affirmative action measures to improve equality in health status is explored, given the increasingly unacceptable disparities in health among subgroups of women within countries

An Appropriate Parameterized Utility Technique On Heterogeneous Server Dependencies

A new server-based approach incorporated in Heterogeneous Servers. Current cloudinfrastructures are mostly homogeneous composed of a large number of machines of the same type – centrally managed and made available to the end user.In a cloud computing pattern, multiple resources types were utilizing. Users may have diverse resource needs. Furthermore, diversity in server properties/capabilities may mean that only a subset of servers may be usable by a given user. In platforms with such heterogeneity, we identify important limitations in existing multi-resource fair allocation mechanisms, notably Dominant Resource Fairness and its follow-up work. To overcome such limitations, we propose a new server-based approach; each server allocates resources by maximizing a per-server utility function. We propose a specific class of utility functions which, when appropriately parameterized, adjusts the trade-off between efficiency and fairness, and captures a variety of fairness measures. We establish conditions for the proposed mechanism to satisfy certain properties that are generally deemed desirable, e.g., envy-freeness, sharing incentive, bottleneck fairness, and Pareto optimality. To implement resource parameterized mechanism, we develop an iterative algorithm which is shown to be globally convergent on Heterogeneous server dependencies

Towards Viable Large Scale Heterogeneous Wireless Networks

We explore radio resource allocation and management issues related to a large-scale heterogeneous (hetnet) wireless system made up of several Radio Access Technologies (RATs) that collectively provide a unified wireless network to a diverse set of users through co-ordination managed by a centralized Global Resource Controller (GRC). We incorporate 3G cellular technologies HSPA and EVDO, 4G cellular technologies WiMAX and LTE, and WLAN technology Wi-Fi as the RATs in our hetnet wireless system. We assume that the user devices are either multi-modal or have one or more reconfigurable radios which makes it possible for each device to use any available RAT at any given time subject to resource-sharing agreements. For such a hetnet system where resource allocation is coordinated at a global level, characterizing the network performance in terms of various conflicting network efficiency objectives that takes costs associated with a network re-association operation into account largely remains an open problem. Also, all the studies to-date that try to characterize the network performance of a hetnet system do not account for RAT-specific implementation details and the management overhead associated with setting up a centralized control. We study the radio resource allocation problem and the implementation/management overhead issues associated with a hetnet system in two research phases. In the first phase, we develop cost models associated with network re-association in terms of increased power consumption and communication downtime taking into account various user device assumptions. Using these cost models in our problem formulations, the first phase focuses on resource allocation strategies where we use a high-level system modeling approach to study the achievable performance in terms of conflicting network efficiency measures of spectral efficiency, overall power consumption, and instantaneous and long-term fairness for each user in the hetnet system. Our main result from this phase of study suggests that the gain in spectral efficiency due to multi-access network diversity results in a tremendous increase in overall power consumption due to frequent re-associations required by user devices. We then develop a utility function-based optimization algorithm to characterize and achieve a desired tradeoff in terms of all four network efficiency measures of spectral efficiency, overall power consumption and instantaneous and long-term fairness. We show an increase in a multi-attribute system utility measure of up to 56.7% for our algorithm compared to other widely studied resource allocation algorithms including max-sum rate, proportional fairness, max-min fairness and min power. The second phase of our research study focuses on practical implementation issues including the overhead required to implement a centralized GRC solution in a hetnet system. Through detailed protocol level simulations performed in ns-2, we show an increase in spectral efficiency of up to 99% and an increase in instantaneous fairness of up to 28.5% for two sort-based user device-to-Access Point (AP)/Base Station (BS) association algorithms implemented at the GRC that aim to maximize system spectral efficiency and instantaneous fairness performance metrics respectively compared to a distributed solution where each user makes his/her own association decision. The efficiency increase for each respective attribute again results in a tremendous increase in power consumption of up to 650% and 794% for each respective algorithm implemented at the GRC compared to a distributed solution because of frequent re-associations

The role of Criticism in the Dynamics of Performance Evaluation Systems

Drawing on the concept of « trial », developed by French sociologists, this article analyzes the dynamics of employees’ performance evaluation systems, particularly those involving accounting performance measures. A case study is presented as an illustration of our proposal to consider these systems as one of the major trials in the business world, that is, social arrangements organizing the testing of people and resulting in ordering them, and further in consistent social goods allocation. This analysis emphasizes the role of criticism in the dynamics and evolution of performance evaluation systems and enables us to revisit concepts like controllability or objectivity which have been presented for decades as cornerstones of performance evaluation systems either in management control or in human resource management fields.Criticism; performance evaluation systems; fairness; objectivity; controllability; legitimacy; bonus